HEMORRHAGIC TRAUMA — FLOWCHART

Version May 20, 2022

Essential rules

Always place the tourniquet as close as possible to the wound and note the time
Ensure the tourniquet is tight enough to stop blood flow completely
Do not remove a foreign object — do not apply direct pressure
When bandaging hands or feet, place a bandage between the fingers/toes

🩸 Tourniquet — 3rd resortIf, despite 2 pressure dressings + direct pressure + indirect pressure, the bleeding is still active, apply the tourniquet.

💨 OxygenAdminister high-concentration oxygen if available (100% oxygen mask).

🌡 Hemorrhagic shockCover the victim with a warm or foil blanket. Keep the victim calm. Loosen clothing.

🧊 Internal bleedingElevate the limb if possible. Apply ice at the site of the trauma. Loosen clothing.

📊 Continuous reassessmentReassess the victim's vital signs (ABC) frequently.

🏥 Mandatory consultationSeek care at a hospital by calling 911.

TYPE OF HEMORRHAGE

🩸 External bleeding

Is the hemorrhage life-threatening?

YES

Direct manual pressure for initial control

🩹 Immediate tourniquet
as close as possible to the wound + note the time

Direct pressure on the wound

Is the wound still bleeding?

YES

Pressure dressing
(distal → proximal)

Is the wound still bleeding?

YES

Add a 2nd dressing pressure dressing

Is the wound still bleeding?

YES

Indirect pressure relative to the wound

Is the wound still bleeding?

YES

🩹 Tourniquet
as close as possible to the wound + note the time

🫀 Internal bleeding

Immediate actions

🧊 Apply ice at the site of the trauma

↑ Elevate the limb if possible

👔 Loosen clothing

Stabilization — Always perform

💨 High-concentration oxygen
(100% mask if available)

🌡 Cover the victim
(warm or foil blanket)

🤫 Keep the victim calm

👔 Loosen clothing

Reassess frequently
vital signs (ABC)

📞 Seek care at a hospital
by calling 911

Once the hemorrhage is controlled — In all cases

💨 High-concentration oxygen
(if available)

🌡 Cover the victim
(warm / foil blanket)

🤫 Keep the victim calm

📊 Reassess vital signs (ABC)

📞 Hospital via 911